Predictors of performance-based measures of instrumental activities of daily living in stroke survivors

Abstract

The aim of this dissertation was to investigate the relationship between cognitive domains/executive functions and performance on measures of Instrumental Activities of Daily Living (IADLs) in stroke survivors. Fifty-two stroke survivors completed assessments of immediate memory, visuospatial/constructional skills, language, attention, delayed memory, executive functions (i.e., inhibition and flexibility, concept-formation and problem solving, abstract thinking, deductive thinking, and verbal abstraction), and two performance-based measures of IADLs. Results indicated significant correlations between the UCSD Performance-based Skills Assessment (UPSA), a measure of IADLS, and immediate memory, visuospatial/constructional skills, language, delayed memory, and executive functions (i.e., concept formation and problem solving, flexibility of thinking, and verbal abstraction). In regards to the Executive Function Performance Test (EFPT), the second measure of IADLs, significant correlations were found between the EFPT and visuospatial/constructional skills, language, delayed memory, and executive functions (i.e., concept formation and problem solving, and flexibility of thinking). Hierarchical multiple regressions demonstrated that only language significantly predicted UPSA total scores and no cognitive domains and executive functions significantly predicted EFPT total scores. These results have several implications. For example, cognitive domains and executive functions are important in predicting a stroke survivors’ level of functioning, and not as individual predictors but rather as a set of cognitive abilities. Limitations of this study and future research directions are discussed.